The NIMH-Funded “Turtle Program:” Helping Inhibited Preschoolers Come Out of Their Shells.
Fifteen to 20% of young children can be classified as behaviorally inhibited (BI) during infancy, meaning that they consistently respond to unfamiliar situations, objects, and people with negative emotion and withdrawal. Roughly half of infants classified as BI remain so throughout childhood. Prospective studies demonstrate that stable BI across infancy and early childhood is associated with the development of later anxiety, particularly social anxiety disorder—suggesting a need for early intervention.
Parenting characterized by inappropriate warmth and high levels of control, intrusiveness, and overprotection predicts both the stability of BI over time and the development of later anxiety. Moreover, maternal overcontrol moderates risk for anxiety, meaning that children with stable BI who also experience maternal overcontrol are at greatest risk for adolescent social anxiety. Theory holds that parents of children high in BI perceive them as vulnerable and respond by stepping in to relieve their children from anxiety-provoking situations. Over time, these children become increasingly dependent on their parents and come to believe they cannot deal with anxiety-provoking situations on their own.
Following from this transactional model, Dr. Andrea Chronis-Tuscano and Dr. Ken Rubin from the Department of Human Development and Quantitative Methodology previously received National Institute of Mental Health (NIMH) funding to develop and evaluate an early intervention program for preschoolers displaying high BI and their parents. The “Turtle Program” targets parent and child behavior using an adaptation of Parent–Child Interaction Therapy (PCIT) and a child intervention designed to improve social interaction and emotion regulation. Drs. Chronis-Tuscano and Rubin were recently awarded a $3.1 million grant from the NIMH to evaluate the Turtle Program compared to a parent-only psychoeducation group, and to examine mediators and moderators of intervention effects. Measures include diagnostic interviews, laboratory observations of parenting, preschool classroom observations, physiological indices of child emotion regulation and parent/teacher questionnaires. This early intervention research holds potential to place young children who are temperamentally at risk for anxiety on a healthier developmental trajectory.